How to help kids that are afraid of masks due to COVID-19

By Dr. Marni Nagel, pediatric psychologist at CHOC Children’s

It is normal for children to have fears. Some kids are afraid of the dark, some are afraid of monsters and others are afraid of masks. We are experiencing an unprecedented time, full of uncertainty, which can make previous fears even stronger or bring on new ones.

The Centers for Disease Control has recently recommended that  children over the age of 2 years and adults wear masks in all public spaces. Some children may incorporate mask wearing into their daily lives with ease, while others may find it odd, uncomfortable or even scary. If your child is having trouble wearing a mask, here are some tips on how to ease their fears:

Explain the why

  • Explain why you want your child to wear a mask using short, clear words, making sure that you use language that your child can easily understand. You might say, “Putting on this mask helps your body stay healthy. It also helps other people stay safe and healthy.”
  • If children want more information, answer their questions.

Get creative                                                                                                   

  • Show your child pictures or videos of other children wearing masks and having fun.
  • Be creative with your masks by having your child choose the color, pattern, design or fabric. Depending on the type of mask, you can even put stickers, sequins or gems/rhinestones on them to decorate. The more your child is involved in creating the mask, the better.
  • Children can draw pictures or write stories about characters wearing masks and having fun or doing important jobs.
  • Engaging in fun activities while wearing masks can help distract your child so that they might not even notice that they have a mask on after awhile. You can play games, color, read books, dance, or do any other activity that you like.
  • You can use masks during pretend play to be their favorite superhero or animal. Children may want to wear their masks more if it helps them to get into character. They can also put masks on their favorite stuffed animals and dolls, perhaps even having matching ones for themselves.

Give your child a sense of control and accomplishment

  • Have your child choose a couple of masks that they really like and then before wearing a mask, they can choose which one they want to wear that day. You can also then ask, “Which mask do you want to wear today?” instead of asking, “Do you want to put on your mask?” Don’t give children a choice where none exists, such as wearing a mask in the first place. Allowing a child to choose which mask they would like to wear gives your child some control which can help increase comfort.
  • To increase a child’s sense of control, they can also select a mask for you to wear when you leave the house together.
  • Make sure to praise your child when they do a great job wearing their mask. They will feel proud of themselves when you acknowledge their accomplishment.
  • Children can also earn a reward when they wear their masks when asked. Find a reward that your child would like and that is reasonable for you to provide, such as a special activity with you, bonus time playing their favorite game, or picking their favorite food for dinner. The closer in time that you can give the reward to the mask wearing, the better.

Practice makes perfect

  • Model for children how and when to wear masks by setting an example yourself.
  • Practicing wearing masks before you need to helps the mask not seem so strange or unusual. If they have trouble putting one on, have them start with a favorite toy or doll.

If you sense that your child is afraid, here are some additional ways you can help them feel more comfortable wearing a mask amid the COVID-19 pandemic.

  • Encourage your child to express their fears and let them know that everyone feels happy, sad, angry and worried sometimes — even parents.
  • Listen to what your child has to say and let them know that it is ok to feel that way.
  • Comfort your child by letting them know that you are here and ready to help. Often holding their hand or giving a hug is reassuring.
  • Help calm your child down by taking a deep breath and counting to three
  • Use positive self-statements. Teach your child to say, “I can do this. I am going to be OK.”
  • Start off small when practicing. Determine what your child is comfortable with, such as holding the mask in their hand or holding the mask to their face but not securing it in place and start there. Provide them with an enjoyable activity to do while practicing.
  • Give plenty of opportunities to practice.

This article was last updated on May 18, 2020.

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How to help your teen cope with COVID-19 cancellations

By Dr. Mery Taylor, pediatric psychologist at CHOC Children’s

To high school seniors, schools being closed doesn’t equal a vacation – to them, this is time they won’t get back with their friends.  It’s normal for teens to feel anxious during this period of their lives, as they close one chapter and begin another. However, teens may feel especially anxious as they realize they may never walk through their high school hallways again, attend prom, perform in their final theater production, compete in their final season, or celebrate graduation.

If you’re a parent or guardian of a teen who is struggling with a loss of control and trying to cope with cancelled celebrations, here’s tips for talking about it and coping.

Allow your teen to grieve

For most high school seniors, sometime in March 2020 they unknowingly experienced their last regular day of school with so many things left undone. I’m sure there were tears shed as this realization set in, along with confusion, anxiety and despair at the loss of their senior year.

During this time, it will be important to allow your student to cope and grieve in her own way. Some students will cope by throwing themselves into their academics, focusing on end of the year projects, and last-minute scholarship applications. Others may struggle through the typical stages of grief — denial, anger, depression, bargaining and acceptance. It is typical to jump back and forth between these stages.

As a parent, you may find yourself in a similar boat — accepting the new normal, only to be saddened the next day when you realize another disappointment due to COVID-19. This is normal. Many people feel like this when experiencing a loss of control over their circumstances.

Use dialectical behavioral therapy (DBT) skills to help you feel back in control

During this time of uncertainty, your teen may be struggling with a loss of control. Using skills associated with dialectical behavioral therapy (DBT), you and your teen can help to regain that lost sense of control.

  • Accept your emotions — What you are going through is not normal. What is normal is feeling emotional in these circumstances. Remember, you are the boss of your emotions. Name the emotion and put a label on it. Take a break and spend some time soothing yourself. The idea is to not let your emotions stop you from doing what you can.
  • STOP — This stands for stop, take a step back, observe and proceed Take a step back and observe your emotions. Let your emotions calm. Then observe the situation as you would if it were someone else facing it. What would you tell someone else to do?
  • Practice radical acceptance — Radical acceptance is the complete and total acceptance of reality. This means that you accept the reality in your mind, heart and body. You stop fighting against the reality and accept it.
  • Use your wise mind —Make decisions about the situation with your wise mind. Your emotion mind will urge you to give up, act impulsively, rage, or give up when faced with disappointment. Wait for your wise mind to be in charge. Your wise mind can take in new information, be flexible in considering alternatives, and be creative in thinking of solutions.

Marking this milestone

Taking the time to celebrate milestones is an important stepping stone in a person’s life, and an opportunity to observe achieving a goal or the fact that someone is entering a new stage in life. A high school graduation marks a time of academic success and transition to adulthood. Even though the current senior class’ year was cut short, it does not make their efforts any less significant.

Senior commencement ceremonies have always been just as much about the students’ past accomplishments as a view toward their future. Particularly, in these times, it will be important to highlight their strengths and virtues as they enter the adult world. Finally, marking this milestone is also an opportunity for the caregivers, teachers, family and friends, who have watched them grow and work hard for this moment, to share in the student’s triumphs and acknowledge their hard work.

The celebration

The celebration or milestone you and your student had originally envisioned may not look the same today, but it can be just as memorable. Take time to talk through what is important to you and your student and find creative ways to make it happen. Here are some ideas to get you started:

  • Mom wants pictures — While practicing social distancing, find a friend or hire a photographer to shoot pictures of your senior in a cap and gown in a lovely outdoor setting.
  • The student wants to dance — Use Zoom to meet up with friends and have a virtual prom.
  • Teachers want to see you in your cap and gown — Organize a drive-by parade around the school.
  • Dad wants to brag — Use FaceTime or Zoom to connect with family and friends. Think about putting a slide show together of your child through the years. Senior, don’t forget to wear your cap and gown.
  • Friends want to graduate together — Create a virtual meetup on Zoom, or practice safe-distancing in a park to ‘move the tassel’ from right to left and throw your caps in the air.
  • Siblings want to participate — Decorate the family car, driveway or front lawn with well-wishes.

Congratulations to the senior class of 2020! Best wishes for your new adventures.

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How to help children who miss their friends amid COVID-19

By Dr. Tiffany Torigoe-Lai, pediatric psychologist at CHOC Children’s

As parents, many of us are coping with the loss of something within our daily lives because of COVID-19, whether it is the loss of a vacation, watching the opening baseball game of the season, or the loss of a job.

Children and adolescents are also coping with various losses within their lives. With the transition to distance learning, many children and adolescents are now coping with the loss of typical school days, celebrating important milestones and achievements like graduation ceremonies, as well as daily social interactions with friends and peers.

One common way children and adolescents cope with changes or challenges within their lives is through social supports from friends and peers. Much of this typically happens seamlessly and without planning, through regular interactions on the playground, between classes in the halls, out on the soccer field, or even during classes through short interchanges with their desk mate. However, in the current climate, children and adolescents are more isolated from one another and may be missing close physical and emotional connection to others their age. Here are a few ways that you can help your children who miss their friends amid the COVID-19 pandemic:

Ask open-ended questions about your child’s friendships, such as why they miss their friends, what do they miss about their friends, and what makes a good friend. This will help them reflect on what they’re feeling. Acknowledge their feelings by saying something like, “I hear that you really miss your friends.” Also let them know how you feel, too. You won’t be putting any thoughts into their head. Most likely they’ve already been thinking or feeling this way and you’ve just made it OK for them to express their grief. Many children and adolescents may be grieving the loss of that connectedness to others. Holding in intense emotions can lead to further issues, such as behavioral outbursts, low mood and withdrawal from others. So, by helping them express their emotions and not trying to “fix it” for them, you are helping them to cope with the pain or grief that they are feeling.

Encourage them to share how they’re feeling with their friends. People tend to withhold and/or further isolate themselves when they are experiencing symptoms of anxiety and depression, particularly during times when they need social support the most. By encouraging your child to express their feelings to their friends, you are also helping other children and adolescents in need of social connection. At the same time, expressing emotions to friends helps your child to develop prosocial skills. Prosocial skills are social behaviors that help promote empathy and kindness toward others and they are essential to social-emotional development. Prosocial behaviors have been associated with positive self-concept, positive peer relationships, increased peer acceptance and decreased behavioral issues. You might suggest that their friends likely feel the same and might welcome the chance to talk. Suggest they start by saying something like, “I wonder if you’re feeling that it’s really sad to miss graduation; I’m feeling that way!”

Help them establish new ways to continue social interactions. Set up weekly play dates or game nights through video conferencing apps. Don’t wait to do family and friend get-togethers until after COVID-19 passes. Continue regular family and school-based celebrations, such as birthday parties or silly hair day, through virtual means. Encourage your child to write letters or mail art to their friends. Typical social interactions for older children and adolescents are not often manufactured or mediated by parents; however, during this time, you may need to take a more active and encouraging role to guide your child to find new ways to interact with their friends. Understand that many children are still interacting socially with friends while engaged in online gaming. Talk to them about online safety and your rules about limits to online usage to help set your child’s expectations.

We are all finding creative ways to physically distance ourselves without socially distancing and to manage all of the difficult emotions this time brings. You can help your children navigate these difficult times and they may surprise you with some creative ideas themselves.

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Tips for parents of teens struggling with stay-at-home orders

By Scott Ryan, mental health therapist, Intensive Outpatient Program at CHOC Children’s

Many teens are complying with stay at home orders and social distancing during the COVID-19 pandemic. However, many of us have also heard stories about teens who were seen hanging out with friends in large groups, celebrating birthday parties in person, as well as being upset with parents who are trying to implement rules to keep their families safe. For those cases where teens are struggling to understand the seriousness of the pandemic, and observe social distancing, the question is, how do we promote increased teen understanding and compliance?

Understanding teen brain development

To understand why teens may be struggling to understand the importance of these restrictions, it’s important to remember that their brains are not yet fully formed. The human brain does not reach adult maturity until age 25. This is when the pre-frontal lobe — responsible for executive functioning such as decision making and the ability to plan ahead — is fully developed.  This means that although your teen can talk like an adult, they’re less likely to make decisions that reflect a broad and deep understanding of complex situations like the COVID-19 pandemic and the importance of social distancing.

Developmentally, teens are shifting away from families toward a peer-based orientation. This means that they may highly value peer praise and activities as they focus on their peers in an attempt to gain individuality from their family unit.

Teens depend on their social connections. Socializing aids teens’ development, teaches them to form meaningful social groups outside their family and increase their autonomy and independence. Knowing how important socialization is to teens’ development, we can understand why teens might feel so constrained by social distancing. It’s natural for teens to feel disappointed that they can’t see their friends in person right now. Here’s advice on talking to kids about disappointment.

Validate your teens’ situation

Acknowledge the difficulties your teen is experiencing. The difficulties they are facing right now are different from their younger siblings or from you. To the teen, it may not feel like just a matter of putting things on hold, but rather more like interfering with future survival or being able to exist independent of their family. There is a biological process driving teens to want to spend time with their peers, no matter how much they love their family members. This is a normal developmental process.

The teen drive to socialize is in opposition to possible other values such as protect my family, try to do no harm, be mindful to others. As a parent, you can validate their desire to socialize while reminding them of their other values. How are their actions reflective of both sets of values? Work with them to find a middle path, a balance between the need to socialize with peers while upholding their other values. Here’s some ideas for how teens can get together virtually with friends.

Help teens explore the “why”

There are graphics and virtual animations online and on social media that visually show how social distancing helps to decrease the spread of COVID-19. Teens like to explore and come to their own conclusions, so you can ask them to look at the animations and explain to you how and why social distancing seems to work.

Acceptance vs. change

An important balance to strike is between acceptance vs. change. When practicing acceptance, a parent may say, “The way you are feeling is ok. I understand how difficult this is for you.” When teens feel they are being forced to change, they may hear things like, “I want you to limit close physical interaction. Please wear a mask.”

If parents take time to genuinely acknowledge the challenges of being an isolated teen, it sets the stage for possible change messages. Validate your teen genuinely before asking for any change. If teens feel validated and that their parents are appreciating their sacrifices, they are more willing to change.

Helping teens make sense of sacrifices

It’s important for parents to help their teens make sense of the sacrifices they are making. Although COVID-19 seems to affect youth less harshly than adults, they could be asymptomatic and unknowingly pass symptoms to their parents or grandparents – or their friends’ parents or grandparents. Remind them that by staying home and social distancing, they are protecting those in their community who are at greater risk. Remind your teens that this pandemic – and their need to make sacrifices – won’t last forever.

Praise your kids liberally

Studies shows that rewarding desired behaviors is significantly more effective than punishing non-desired behaviors. Catch your teen being good, and reward them through verbal praise or other tangible rewards. Let them know that you appreciate their willingness to limit social exposure and that you notice they are doing the right thing, even when it may not feel very rewarding.

Messages matter

Do your best to be consistent in establishing your family’s rules. If the rule is you need to wear a mask when we are in a public setting like the grocery store, make sure that you enforce it every time you go out. Enforcing a rule only sometimes almost always leads to poor compliance.

Remind your teen of your family’s choices

There are many differing views out there about how to best combat this pandemic. Validate the multiple points of view about the pandemic that your teen may be aware of. You could say something like, “Yes, some people are saying (this), and we are going to follow (this) because we are doing our part for (insert value/reason here).”

Reframe safety protocols as common etiquette

We teach our children proper ways to act from a young age. Wash your hands; say please and thank you. Doing these things helps us build the type of community we want to live, and communicates to others that we care about them, demonstrated in our public actions.

We can teach our teens that wearing a face covering  and maintaining six feet of distance from others in public shows that we are mindful and caring, and that we value others’ lives, too. Even if we don’t think we have COVID-19, even if we are not personally worried about getting the virus, we will look out for each other.

Following this common etiquette communicates to those around us that just as we value each other’s health and safety as much as we do our own, and that making sacrifices supports our community. Communicating these messages to your teen frequently will reinforce the meaning behind these safety protocols and increase the likelihood that they will be willing to make sacrifices and practice social distancing during this time.

Praise yourself as a parent

Remind yourself that as a parent, you are doing the best that you can! Remind yourself that this is new territory for everyone, and that each one of us is trying to get our needs met in the ways that have worked for us before. Give yourself a pat on the back that you have a teen who is listening to you as best they can, whose behavior reflects many of your same values. We are all doing the best that we can and you are doing the best that you can for your children.

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Cómo hablar con los niños sobre la decepción durante COVID-19

Por la Dra. Mery Taylor, psicóloga pediátrica en CHOC Children’s 

Con las escuelas cerradas y la práctica del distanciamiento social en vigencia, es ciertamente comprensible que los niños se sientan decepcionados en este momento por perderse las fiestas de cumpleaños, las excursiones o las vacaciones que habían estado esperando.  Si su hijo o adolescente se siente decepcionado en este momento, permítale expresar sus sentimientos y validarlos.  Comparta sus propias decepciones y cómo usted maneja sus sentimientos.

Como padre, es difícil ver a un hijo experimentar la decepción.  Como adultos, tenemos la perspectiva de saber que habrá otras fiestas de cumpleaños, excursiones y celebraciones en el futuro.  Durante este período, los niños se sentirán más reconfortados con  las palabras de seguridad de los padres expresándoles que pasarán juntos estos tiempos difíciles y que finalmente la vida volverá a la normalidad.

Recuérdeles a los niños por qué las cosas han cambiado

Puede ser útil recordarles por qué las cosas son diferentes en este momento.  Recuérdele a su hijo que, como comunidad, nos estamos uniendo para “aplanar la curva” y evitar la propagación de COVID-19.

Hable sobre los cambios de planes lo antes que pueda

Para la mayoría de los niños pequeños, será útil comenzar a hablar sobre los cambios de planes más vale temprano que tarde.  Comience despacio y vuelva al tema varias veces, cada vez agregando un poco más de detalle.  Solicite la opinión de sus hijos sobre cómo pueden cumplir con el evento, aunque es posible que no puedan ir físicamente a ningún lugar o tener interacciones en persona. Por ejemplo, ¿pueden crear una tarjeta de cumpleaños para un amigo cuya fiesta fue cancelada y enviársela por correo, y llamarlo o hacer un chat de video para desearle un feliz cumpleaños?

Limite la exposición de los niños a las noticias

En este momento, la mayoría de los niños están en casa sin poder ir a la escuela y está claro que algo ha cambiado drásticamente en su mundo. Si bien es importante mantener a los niños muy pequeños alejados de las noticias diarias que pueden incluir el número de muertos y las especulaciones, los padres deben ser honestos sobre lo que estamos tratando de lograr mediante el distanciamiento social.  He aquí una explicación del distanciamiento social. Podría ser útil preguntarles lo que ya saben, desacreditar información errónea y proporcionar información adicional para una mejor comprensión y aclaración.

Consejos para niños mayores

Es probable que los niños mayores y los adolescentes sean más conscientes de que hay ocasiones especiales que quizás nunca regresen, como bailes escolares, representaciones teatrales y graduaciones.  Asegúreles que su escuela y su maestro harán lo que puedan para resarcir esto.

Deje que usen su imaginación

Diviértanse pensando en fiestas de cumpleaños con maquillaje, excursiones y otras reuniones con familiares y amigos.  Permítales usar su imaginación sobre las decoraciones que tendrían, la comida que comerían y las personas que más quisieran ver.

Celebre los eventos especiales de una manera creativa:

  • Organice una fiesta virtual: arme un telón de fondo, haga una lista de reproducción de música y cree un juego temático.
  • Únase con los amigos para un recorrido virtual por el museo. Muchos museos y otras atracciones ofrecen visitas virtuales gratuitas durante este tiempo.
  • Ayude a su hijo a preparar una comida o un postre particular para las vacaciones o para un día especial.
  • Salga a la naturaleza para una aventura única con aquellos con quienes vive.
  • Llame a su amigo en su cumpleaños y cántele “Feliz cumpleaños”.
  • Comparta una comida virtual con amigos y familiares.
  • Organice una noche de juegos virtuales.

Crear hábitos de resistencia

Aunque esta pandemia no es la situación que hubiéramos elegido para que nuestros hijos se enfrenten, experimentar eventos adversos, con el apoyo de sus padres, ayudará a los niños a desarrollar la capacidad de resistencia. Ellos podrán mirar hacia atrás en este momento y reflexionar sobre cómo fueron creativos para encontrar formas de conectarse con sus amigos en línea, cómo encontraron nuevas formas de entretenerse en casa y cómo perseveraron ante nuevos desafíos, como asistir a la escuela por internet.

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